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Referral Forms

We are currently experiencing a large influx of CASAs waiting for case assignment. Your help in finding cases to assign CASAs to would be greatly appreciated.

Thank you for visiting our on-line referral form. Please fill out one form for each family and remember that we do not accept cases where the children are placed outside of DeKalb County. The more complete information we receive on this case, the sooner our staff can process the request. Feel free to contact the CASA office by email at dekalbcasa@dekalbcasa.org or call (404) 378-0038 if you have any questions or to check on the status of your referral. Your assistance and support of our program is greatly appreciated.

Please fill out and submit the following information to request a CASA assignment.

Person Making Referral:


Date of Referral:


Number you can be reached at for further information:
Your Email*:


Child(ren):

Legal Mother's Name:

Judge assigned:

Child Advocate Attorney assigned:

Case Manager assigned:

Next Hearing/Panel Date:

Placement Contact Name:

Placement Address, City, State & Zip Code:


Source of Referral


Issues:
Issues for CASA